| 黄山,郑穗生,管松,邹立巍,王超.颈动脉粥样硬化斑块MDCT定量分析[J].中国医学影像技术,2015,31(11):1671~1674 |
| 颈动脉粥样硬化斑块MDCT定量分析 |
| Quantitative analysis of carotid atherosclerotic plaque by MDCT |
| 投稿时间：2015-04-21 修订日期：2015-09-29 |
| DOI：10.13929/j.1003-3289.2015.11.017 |
| 中文关键词: 体层摄影术,X线计算机 颈动脉粥样硬化 斑块 |
| 英文关键词:Tomography, X-ray computed Carotid atherosclerosis Plaque |
| 基金项目:安徽省质量工程项目-医学影像教学团队(2014jxtd119)。 |
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| 中文摘要: |
| 目的 探讨采用颈动脉粥样硬化斑块平扫CT值和强化幅度预测脑血管症状的价值。方法 纳入87例拟诊为颈动脉粥样硬化接受MDCT平扫及CTA的患者,根据有无脑血管症状分为有症状组(n=38)及无症状组(n=49),通过手动勾画ROI的方法测量CT平扫及CTA图像上斑块非钙化部分的CT值,采用独立样本t检验比较组间差异。应用ROC曲线分析采用平扫CT值及强化幅度判定是否引起脑血管症状的效能,并采用Z检验对曲线下面积进行比较。结果 有症状组和无症状组颈动脉斑块平扫CT值分别为(45.58±8.94)HU和(31.09±6.83)HU,二者差异有统计学意义(t=-8.569,P<0.001);有症状组颈动脉斑块强化增幅大于无症状组(t=-3.421,P=0.001)。ROC曲线阈值分析显示,平扫CT值最佳临界值为37.20 HU,判定是否引起脑血管症状的敏感度为92.10%(35/38),特异度为81.63%(40/49),准确率86.21%(75/87),ROC曲线下面积为0.937。强化幅度最佳临界值为10.1 HU,其敏感度为76.32%(29/38),特异度为63.27%(31/49),准确率为68.97%(60/87),曲线下面积为0.735;二者曲线下面积的差异有统计学意义(Z=3.613,P<0.01)。结论 颈动脉斑块非钙化部分平扫CT值和强化幅度与脑血管症状有关;斑块平扫CT值对判断是否引起脑血管症状的效能优于斑块强化幅度。 |
| 英文摘要: |
| Objective To explore the predictive value of pre-contrast CT value and enhancement amplitude of carotid atherosclerotic plaque for cerebrovascular symptoms. Methods Totally 87 patients diagnosed as carotid atherosclerosis were included and accepted non-enhanced and enhanced MDCT scan. According to the presence or absence of cerebrovascular symptom, the patients were divided into symptomatic group (n=38) and asymptomatic group (n=49). The CT values were measured on non-enhanced and enhanced CT scan by manually outlining the ROI on non-calcified plaque section, and then the differences between two groups were evaluated using the independent t-test. The ROC curve was used to evaluate the optimal threshold and diagnostic efficacy of pre-contrast CT value and enhancement amplitude in predicting cerebrovascular symptom and the difference of area under ROC curve (AUC) were analyzed using Z test. Results The pre-contrast CT value of symptomatic group and asymptomatic group were (45.58±8.94)HU and (31.09±6.83)HU, respectively, and the difference was statistically significant (t=-8.569, P<0.001). Enhancement amplitude of the symptomatic group was higher than that in asymptomatic group (t=-3.421, P=0.001). ROC analysis showed that 37.20 HU of pre-contrast CT value was the optimal threshold to predict cerebrovascular symptom, the specificity, sensitivity and accuracy was 92.11% (35/38), 81.63% (40/49), 86.21% (75/87), respectively, the AUC was 0.937, while the optimal threshold of enhancement amplitude was 10.1 HU, the specificity, sensitivity and accuracy was 76.32% (29/38), 68.97% (60/87), 63.27% (31/49), respectively, the AUC was 0.735. The difference of AUC between two groups was statistically significant (Z=3.613, P<0.01). Conclusion The pre-contrast CT value and enhancement amplitude on part of non-calcified carotid artery plaque have relationship with cerebrovascular symptom. The pre-contrast CT value of plaque is superior to enhancement amplitude in evaluating whether caused cerebrovascular symptom. |
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